Department of Endemic Medicine and Liver Unit, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt.
Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abdom Radiol (NY). 2019 Feb;44(2):464-472. doi: 10.1007/s00261-018-1732-8.
Role of acoustic radiation force impulse (ARFI) elastography, in transplant setting, is not well established. We aimed to define the normal mean values of the liver stiffness by ARFI Elastography in healthy liver donors and to evaluate ARFI elastography as predictor of graft fibrosis post living donor liver transplant (LDLT) in comparison to other non-invasive methods (transient elastography [TE], APRI and FIB4).
A total of 100 subjects (70 recipients and 30 donors) were recruited. APRI and FIB4 scores were calculated for all recipients. TE and ARFI elastography (Siemens Acuson S2000 Ultrasound System, Germany) were performed to all subjects. All donors and only 30 recipients had liver biopsy. Significant fibrosis was defined as ≥ F2.
The mean ARFI velocity among the donors was 1.05 ± 0.09 m/s. Regarding the recipients: mean age was 49.5 ± 8.49 years, 85.7% males, fibrosis stages < F2 were the most frequent stages by liver biopsy (86.7%) and TE (67.1%). ARFI median was significantly correlated with TE median, APRI and FIB-4 (r = 0.888, p = 0.000; r = 0.62, p = 0.000, and r = 0.585, p = 0.000, respectively). ARFI performed well in discriminating patients with ≥ F2 (AUROC = 0.93, 95% CI 0.86-0.99, p < 0.01) with best cutoff median value of 1.34 m/s (sensitivity 90%, specificity 82%).
ARFI can be used as a reliable method in assessment of significant fibrosis post-LDLT.
声辐射力脉冲（ARFI）弹性成像在移植环境中的作用尚未得到充分确立。本研究旨在确定健康肝供体的肝硬度的正常值，并通过 ARFI 弹性成像评估其在活体肝移植（LDLT）后移植肝纤维化的预测作用，与其他非侵入性方法（瞬时弹性成像 [TE]、APRI 和 FIB4）进行比较。
共纳入 100 例患者（70 例受体和 30 例供体）。所有受体均计算了 APRI 和 FIB4 评分。所有受检者均行 TE 和 ARFI 弹性成像（德国西门子 Acuson S2000 超声系统）检查。所有供体和仅 30 例受体进行了肝活检。显著纤维化定义为≥F2。
供体的平均 ARFI 速度为 1.05±0.09 m/s。对于受体：平均年龄为 49.5±8.49 岁，85.7%为男性，肝活检和 TE 最常见的纤维化分期为<F2（86.7%和 67.1%）。ARFI 中位数与 TE 中位数、APRI 和 FIB-4 显著相关（r=0.888，p=0.000；r=0.62，p=0.000 和 r=0.585，p=0.000）。ARFI 在区分≥F2 的患者方面表现良好（AUROC=0.93，95%CI 0.86-0.99，p<0.01），最佳截断中位数为 1.34 m/s（敏感性 90%，特异性 82%）。
ARFI 可作为 LDLT 后评估显著纤维化的可靠方法。
